Skip to main content
The Journal of Headache and Pain logoLink to The Journal of Headache and Pain
. 2009 Sep 10;10(6):423–429. doi: 10.1007/s10194-009-0150-2

Pain perception and laser evoked potentials during menstrual cycle in migraine

Marina de Tommaso 1,4,, Massimiliano Valeriani 2, Michele Sardaro 1, Claudia Serpino 1, Olimpia Di Fruscolo 1, Eleonora Vecchio 1, Rosanna Cerbo 3, Paolo Livrea 1
PMCID: PMC3476220  PMID: 19763770

Abstract

The association between estrogens “withdrawal” and attacks of migraine without aura is well-known. The aim of the study was to examine the features of laser evoked potentials (LEPs), including habituation, in women suffering from migraine without aura versus healthy controls, during the pre-menstrual and late luteal phases. Nine migraine without aura and 10 non-migraine healthy women, were evaluated during the pre-menstrual phase and late luteal phase. The LEPs were recorded during the inter-critical phase. The right supraorbital zone and the dorsum of the right hand were stimulated. Three consecutive series of 20 laser stimuli were obtained for each stimulation site. Laser pain perception was rated by a 0–100 VAS after each stimulation series. Migraine patients exhibited increased LEPs amplitude and reduced habituation compared to normal subjects. Laser-pain perception was increased during the pre-menstrual phase in both patients and controls. Migraine patients and controls showed increased P2 and N2–P2 amplitude in the pre-menstrual phase, on both stimulation sites. During the pre-menstrual phase the N2–P2 habituation appeared to be reduced in both migraine and healthy women. The estrogen withdrawal occurring during the menstrual cycle may favor reduced habituation of nociceptive cortex, which may facilitate pain symptoms and migraine in predisposed women.

Keywords: Migraine, Menstrual cycle, Pain sensitivity, Laser evoked potentials

Full Text

The Full Text of this article is available as a PDF (283.0 KB).

Acknowledgments

Conflict of interest

None.

References

  • 1.Craft RM. Modulation of pain by oestrogen. Pain. 2007;132(suppl 1):S3–S12. doi: 10.1016/j.pain.2007.09.028. [DOI] [PubMed] [Google Scholar]
  • 2.Goadsby PJ. Can we develop neurally acting drugs for the treatment of migraine? Nat Rev Drug Discov. 2005;4(9):741–750. doi: 10.1038/nrd1822. [DOI] [PubMed] [Google Scholar]
  • 3.Welch KMA. Brain hyperexcitability. The basis for antiepileptic drugs in migraine prevention. Headache. 2005;45:S25–S32. doi: 10.1111/j.1526-4610.2005.4501008.x. [DOI] [PubMed] [Google Scholar]
  • 4.Welch KMA. Contemporary concepts of migraine pathogenesis. Neurology. 2003;61:S2–S8. doi: 10.1212/wnl.61.8_suppl_4.s2. [DOI] [PubMed] [Google Scholar]
  • 5.MacGregor AE. Oestrogen and attacks of migraine with and without aura. Lancet Neurol. 2004;3:354–361. doi: 10.1016/S1474-4422(04)00768-9. [DOI] [PubMed] [Google Scholar]
  • 6.Somerville BW. The role of estradiol withdrawal in the etiology of menstrual migraine. Neurology. 1972;22:355–365. doi: 10.1212/wnl.22.4.355. [DOI] [PubMed] [Google Scholar]
  • 7.Brandes JL. The influence of estrogen on migraine: a systematic review. JAMA. 2006;295(15):1824–1830. doi: 10.1001/jama.295.15.1824. [DOI] [PubMed] [Google Scholar]
  • 8.Somerville BW. Estrogen-withdrawal migraine, I: duration of exposure required and attempted prophylaxis by premenstrual estrogen administration. Neurology. 1975;25:239–244. doi: 10.1212/wnl.25.3.239. [DOI] [PubMed] [Google Scholar]
  • 9.Somerville BW. Estrogen-withdrawal migraine, II: attempted prophylaxis by continuous estradiol administration. Neurology. 1975;25:245–250. doi: 10.1212/wnl.25.3.245. [DOI] [PubMed] [Google Scholar]
  • 10.Siniatchkin M, Kropp P, Gerber WD. Contingent negative variation in subjects at risk for migraine without aura. Pain. 2001;94:159–167. doi: 10.1016/S0304-3959(01)00350-5. [DOI] [PubMed] [Google Scholar]
  • 11.Siniatchkin M, Averkina N, Gerber WD. Relationship between precipitating agents and neurophysiological abnormalities in migraine. Cephalalgia. 2006;26:457–465. doi: 10.1111/j.1468-2982.2006.01061.x. [DOI] [PubMed] [Google Scholar]
  • 12.Stening K, Eriksson O, Wahren L, Berg G, Hammar M, Blomqvist A. Pain sensations to the cold pressor test in normally menstruating women: comparison with men and relation to menstrual phase and serum sex steroid levels. Am J Physiol Regul Integr Comp Physiol. 2007;293:R1711–R1716. doi: 10.1152/ajpregu.00127.2007. [DOI] [PubMed] [Google Scholar]
  • 13.Söderberg K, Sundström Poromaa I, Nyberg S, Bäckström T, Nordh E. Psychophysically determined thresholds for thermal perception and pain perception in healthy women across the menstrual cycle. Clin J Pain. 2006;22:610–616. doi: 10.1097/01.ajp.0000210904.75472.63. [DOI] [PubMed] [Google Scholar]
  • 14.Okifuji A, Turk DCJ. Sex hormones and pain in regularly menstruating women with fibromyalgia syndrome. Pain. 2006;7:851–859. doi: 10.1016/j.jpain.2006.04.005. [DOI] [PubMed] [Google Scholar]
  • 15.Ambrosini A, Noordhout AM, Sándor PS, Schoenen J. Electrophysiological studies in migraine: a comprehensive review of their interest and limitations. Cephalalgia. 2003;23(suppl 1):13–31. doi: 10.1046/j.1468-2982.2003.00571.x. [DOI] [PubMed] [Google Scholar]
  • 16.Thompson RF, Spencer WA. Habituation: a model phenomenon for the study of neuronal substrates of behavior. Psychol Rev. 1996;73(1):16–43. doi: 10.1037/h0022681. [DOI] [PubMed] [Google Scholar]
  • 17.Tommaso M. Laser-evoked potentials in primary headaches and cranial neuralgias. Expert Rev Neurother. 2008;8(9):1339–1345. doi: 10.1586/14737175.8.9.1339. [DOI] [PubMed] [Google Scholar]
  • 18.Valeriani M, Tommaso M, Restuccia D, Le Pera D, Guido M, Iannetti GD, Libro G, Truini A, Di Trapani G, Puca F, Tonali P, Cruccu G. Reduced habituation to experimental pain in migraine patients: a CO(2) laser evoked potential study. Pain. 2003;105(1–2):57–64. doi: 10.1016/S0304-3959(03)00137-4. [DOI] [PubMed] [Google Scholar]
  • 19.Tommaso M, Lo Sito L, Di Fruscolo O, Sardaro M, Pia Prudenzano M, Lamberti P, Livrea P. Lack of habituation of nociceptive evoked responses and pain sensitivity during migraine attack. Clin Neurophysiol. 2005;116(6):1254–1264. doi: 10.1016/j.clinph.2005.02.018. [DOI] [PubMed] [Google Scholar]
  • 20.Tommaso M, Baumgartner U, Sardaro M, Difruscolo O, Serpino C, Treede RD. Effects of distraction versus spatial discrimination on laser-evoked potentials in migraine. Headache. 2008;48(3):408–416. doi: 10.1111/j.1526-4610.2007.00857.x. [DOI] [PubMed] [Google Scholar]
  • 21.Tommaso M, Guido M, Libro G, Losito L, Difruscolo O, Puca F, Specchio LM, Carella A. Topographic and dipolar analysis of laser-evoked potentials during migraine attack. Headache. 2004;44(10):947–960. doi: 10.1111/j.1526-4610.2004.04188.x. [DOI] [PubMed] [Google Scholar]
  • 22.Headache Classification Committee (2004) The international classification of headache disorders II. Cephalalgia 24:24–136
  • 23.Biehl R, Treede R-D, Bromm B. Pain ratings of short radiant heat pulses. In: Bromm B, editor. Pain measurement in man. Neurophysiological correlates of pain. Amsterdam: Elsevier; 1984. pp. 397–408. [Google Scholar]
  • 24.Valeriani M, Rambaud L, Mauguière F. Scalp topography and dipolar source modelling of potentials evoked by CO2 laser stimulation of the hand. Electroencephalogr Clin Neurophysiol. 1996;100(4):343–353. doi: 10.1016/0168-5597(96)95625-7. [DOI] [PubMed] [Google Scholar]
  • 25.Cruccu G, Aminoff MJ, Curio G, Guerit JM, Kakigi R, Mauguiere F, Rossini PM, Treede RD, Garcia-Larrea L. Recommendations for the clinical use of somatosensory-evoked potentials. Clin Neurophysiol. 2008;119(8):1705–1719. doi: 10.1016/j.clinph.2008.03.016. [DOI] [PubMed] [Google Scholar]
  • 26.Garcia-Larrea L, Frot M, Valeriani M. Brain generators of laser-evoked potentials: from dipoles to functional significance. Neurophysiol Clin. 2003;33:279–292. doi: 10.1016/j.neucli.2003.10.008. [DOI] [PubMed] [Google Scholar]
  • 27.Leeuw R, Albuquerque RJ, Andersen AH, Carlson CR. Influence of estrogen on brain activation during stimulation with painful heat. J Oral Maxillofac Surg. 2006;64(2):158–166. doi: 10.1016/j.joms.2005.10.006. [DOI] [PubMed] [Google Scholar]
  • 28.Arjona A, Rubi-Callejon J, Guardado-Santervas P, Serrano-Castro P, Olivares J. Menstrual tension-type headache: evidence for its existence. Headache. 2007;47(1):100–103. doi: 10.1111/j.1526-4610.2007.00656.x. [DOI] [PubMed] [Google Scholar]
  • 29.Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis. Headache. 2006;46:365–386. doi: 10.1111/j.1526-4610.2006.00370.x. [DOI] [PubMed] [Google Scholar]
  • 30.Di Clemente L, Coppola G, Magis D, Fumal A, Pasqua V, Di Piero V, Schoenen J. Interictal habituation deficit of the nociceptive blink reflex: an endophenotypic marker for presymptomatic migraine? Brain. 2007;130:765–770. doi: 10.1093/brain/awl351. [DOI] [PubMed] [Google Scholar]
  • 31.Welch KM, Brandes JL, Berman NE. Mismatch in how oestrogen modulates molecular and neuronal function may explain menstrual migraine. Neurol Sci. 2006;27(suppl 2):S190–S192. doi: 10.1007/s10072-006-0599-6. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of Headache and Pain are provided here courtesy of BMC

RESOURCES